Orale Toleranzinduktion bei Typ I-Allergie gegen Ei

Hen egg is an allergen which often occurs in our daily diet, both in open and hidden forms. An allergy against hen egg is often accompanied by severe anaphylactic reactions. Avoiding chicken eggs completely is an enormous challenge in the everyday life. Affected patients are limited in their choice of food and, consequently, in their social life. The patient in the presented case introduced herself in our clinic after she had suffered a severe anaphylactic shock while trying a homemade cake dough, followed by treatment in the intensive care unit. Using skin prick testing and IgE diagnostics, we were able to detect a type I sensitization predominantly to heat-labile single allergens in hen egg. Since the patient could not completely avoid the ingestion of chicken eggs, we started with a specific oral tolerance induction (SOTI) with baked/heated egg. With this treatment, the patient did not suffer severe anaphylactic reactions any more, and was at the same time able to significantly alleviate the restrictions in her daily life. Despite this success, SOTI cannot yet be recommended as a standard treatment due to the lack of established and safe protocols. It should only be considered in special cases such as in this patient.